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Coming To America: Actually, Ebola is Here…and Now!

It has taken a while for the current epidemic of the Ebola Virus Disease (EVD), which is centered in West Africa, to reach America. The current outbreak of the disease was discovered in March 2013. Subsequently, it was determined to have started in Guinea in December 2013. Since then it spread to Liberia, Sierra Leone, Nigeria and Senegal.

It took nine months, but yesterday, the first case was confirmed in the United States. It was bound to happen; just a matter of time. It’s a small world; frequent transcontinental travel heightens exposure and ensures elevated instances of that exposure to persons carrying the virus. This is especially true in countries experiencing an outbreak. The disease, while not highly contagious, is exceptionally infectious.

The disease is caused by the Ebola virus (EBOV). It may be acquired via contact with blood or bodily fluids of infected animals. There are no documented cases of the disease spreading through the air. Once human infection occurs, the disease may spread between people, as well.

Male survivors may be able to transmit the disease via semen for nearly two months. To make the diagnosis, typically other diseases with similar symptoms such as cholera, typhoid fever, malaria, cholera and other viral hemorrhagic fevers are first excluded. To confirm the diagnosis, blood samples are tested for viral antibodies, viral RNA, or the virus itself. Ebola causes viral hemorrhagic fever, which can affect multiple organ systems in the body and is often accompanied by bleeding. Early symptoms include sudden onset of fever, weakness, muscle pain, headaches and a sore throat

Previously, two high profile cases of American exposure and contraction occurred when American health missionaries, Dr. Kent Brantly, of Ft. Worth, Texas, and Charlottean, Nancy Writebol, were infected with the virus in July while working with the Charlotte-based SIM missionary group to treat Ebola patients in Liberia. Both were treated with an experimental drug, and then transferred separately to Emory Hospital in Atlanta. Both have subsequently been determined to be Ebola-free.

Now comes word from U.S. health officials (yesterday) that a yet-to-be-named American man is the first person diagnosed with Ebola in the United States. This person is being treated in Dallas, Texas.

The unidentified man left Liberia September 19th, and arrived in in the United States September 20th, according to Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention. At the time of his arrival in the U.S., the man did not have symptoms. However, four or five days later, he began to exhibit them. He has been hospitalized and isolated at Texas Health Presbyterian Hospital since Sunday. Health Officials, pointing to privacy concerns, declined to release any details about how the patient contracted the virus, what he was doing in Liberia, or the parameters of his treatment plan. Dr. Edward Goodman, of the hospital said, “I can say he is ill. He is under intensive care.”

Because of the nature of spreading the virus, authorities do not suspect that passengers on the patient’s flight are at risk. However, the patient did indicate he had direct contact with several people after he became symptomatic. Medical officials are contacting those people for follow-up. The crew that transported him to the hospital is being held in isolation. None had shown symptoms of the disease as of yesterday.

Dr. Frieden downplayed the risk to public health. No other suspected cases of Ebola have been identified in Texas. He noted, “It’s a severe disease, which has a high-case fatality rate, even with the best of care, but there are core, tried and true public health interventions that stop it. The bottom line here is that I have no doubt that we will control this importation or this case of Ebola so that it does not spread widely in this country.”

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